I recently called every member of my physician group as part of an effort to incorporate feedback on a group policy I was trying to develop.
I'm fortunate to work with folks I truly respect and admire, who collaborate and frequently ask one another to opine in challenging cases. In that spirit, I sought advice and suggestions from folks who would be germane to the policy as well as those who experience suggested might be skeptical of its value.
One of the unexpected aspects of my conversations was that a vocal minority physicians seem to believe that suffering is an inherent element of the physician experience. That without retaining some element of pain, you can't consider yourself a true member of your medical specialty.
I find this interesting, because I've come to enjoy my specialty of emergency medicine immensely more as I've eliminated aggravations. The notion that I'm less of a physician because my practice of medicine is less of a pain in the tuchus runs counter to personal experience.
Not feeling chronically depleted or burnt out has given me a second honeymoon with my specialty, and I love what I do more than I have in years.
The policy I'm designing is intended to address the drawbacks imposed by burnout and aging physiology by implementing a night shift differential.
It was implied by one colleague that by virtue of wanting to reduce my night shifts, I have no place working in emergency medicine. This struck me as odd.
I don't need to go through something I dislike in order to enjoy doing what I love. I don't need to dig out from several feet of snow after a freezing Boston noreaster, nor join my residency classmate in North Carolina piling sandbags last weekend to avert hurricane-related flooding, in order to understand that I thrive best in the direct sunlight of California.
Call me a dandy for where I choose to live? Sticks and stones. Call me a sucker for the price I pay for that privilege? Suit yourself.
But call me less of a physician for reducing obstacles that inhibit my ability to give my patients the best care I'm capable of providing?
Do my patients benefit from a more exhausted, less fit physician with poorer social supports? I beg to differ.
How much suffering is enough to satisfy the imaginary "certificate of mental toughness" others would insist is required to practice emergency medicine? I doubt there's consensus.
The initial ambivalence I felt about my chosen field was that it attracted a high percentage of cowboys and cowgirls. The first several conferences I attended for ACEP, one of our main specialty organizations, inevitably found me in a bar at 2AM listening to a couple of gunslinger residency directors boasting of how crazy their inner city urban knife and gun clubs had become.
Cute, I thought, brilliant (if insecure) docs who feel a need to put their balls or ovaries on public display to let everyone know just how brave they are.
With apologies to Shakespeare, Methinks they doth protest too much. I liked them as people, thought they were fun ambassadors for the field, but we didn't connect so well on a personal level.
What ultimately won me over to the field was that it also attracted a high number of the misfits of medicine, those people who were quirky but passionate and felt completely secure in their eccentricities.
While I liked the cowboys and cowgirls just fine, I really crushed on the musicians, birdwatchers, outdoor dirtbags, creatives and empaths for the downtrodden that were also drawn toward the shiny light of emergency medicine. It's their company that makes me feel a part of something special and exciting and unlike anything else in medicine.
Every specialty has its unique snowflake pattern of aggravations that reduce the joy of medicine and make you want to poke your eye out. No physician should be diminished for opting for a path, however nontraditional, that leaves her with sight preserved.
I'll take no offense if the world's great religions lay claim to martyrs.
But do me a favor. Don't expect me to bear your cross.
